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Chronic Headache Pain

Coping With Chronic Migraines, Tension Headaches and Cluster Headaches


Updated September 24, 2009

Did you know that headaches are one of the leading types of chronic pain? They top the list, right up there with back pain and arthritis. A headache may sound like a fairly minor ailment, but chronic headaches can be debilitating to the people who suffer from them almost every day. Getting a migraine or a cluster headache under control is a bit more complicated than taking two aspirin and calling your doctor in the morning.

In order for a headache to be considered chronic, it has to be present for a minimum of 15 days a month for at least three months in a row. This doesn’t mean you must have a headache for two weeks in a row to fit into this diagnosis: any 15 days in the month will qualify you. Chronic headaches typically come and go, but unfortunately they are present more often than not.

Types of Chronic Headaches

Chronic headaches may be caused by other chronic pain diagnoses, but the three most common types are migraines, muscle tension headaches and cluster headaches.

  • Migraines. The exact cause of migraine headaches are still under debate, but most researchers agree that they are neurological in nature. In addition to head pain, migraines are usually accompanied by other symptoms such as visual disturbances, nausea or a funny taste in the mouth.
  • Tension Headaches. Formerly believed to be caused by muscle tension in the neck and shoulders, tension headaches may actually be a result of the pain control center in the spine receiving too much input from muscles of the head. A tension headache often feels like a band of pressure around the head, and may be accompanied by pain in the neck and shoulders.
  • Cluster Headaches. Cluster headaches are a bit of a medical mystery. They may be caused by vascular changes in the brain, or by a series of activations in certain areas in the brain. Cluster headaches are distinct in that they occur in short bursts over time.

Treating Chronic Headaches With Medications

Depending on the type of headache, a number of different medications are effective in treating migraines, tension headaches and cluster headaches. Some medications are prophylactic, meaning they are taken regularly to ward off a headache before it happens. Others are abortive medications, which are designed to control headache pain once it has begun.

Many chronic headache medications are available over-the-counter, however some require a doctor's prescription. Also, not all of them are taken orally: some chronic headache treatments are available in topical form, such as pain creams or patches.

Complimentary and Alternative Treatments for Chronic Headaches

Many people find relief from chronic headache pain through complimentary and alternative treatments, or CAM's. Some common CAM's for chronic headaches include:

  • Yoga
  • Massage
  • Meditation and relaxation
  • Acupuncture and accupressure
  • Aromatherapy
  • Hypnosis
  • Dietary Supplements

Coping With Chronic Headache Pain

Daily life with chronic headaches can be tough. Sometimes, medications and complimentary treatments aren't enough to help you cope. When you have chronic headaches, seeking support may help you get though the hard times.

Support groups and online pain forums are a great resource for coping strategies. Also, make sure you have a good relationship with your doctor and visit often. Finally, tell your family and friends what you are going through so they understand.


Fumal, Arnaud and Schoenen, Jean. Tension-type Headache: Current Research and Clinical Management. Lancet Neurology, 2008; 7: 70–83.

May, Arne. Cluster headache: Pathogenesis, Diagnosis, and Management. Lancet 2005; 366: 843–55

National Institutes of Health. Medical Encyclopedia: Tension Headache. Accessed April 2, 2009. http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000797.htm

Silberstein, Stephen D. Migraine. The Lancet. Volume 363, January 31, 2004. pp381-391.

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